Zika of late

I had the pleasure of giving a Grand Rounds presentation to Sinai’s Department of Obstetrics and Gynecology yesterday on the Zika virus, focusing on what we’ve learned about it since it’s emergence in this hemisphere in 2016, things of importance that we haven’t figured out yet, and what lies ahead for Zika as a threat in 2018. A few particularly interesting points to me include:

the CDC’s Zika testing algorithm (who to test, and how) is slightly confusing, but hinges both on how sick someone with suspect Zika is, where they’ve traveled to, and the timing

travel counseling amounts to “if you are going to a place with known or recent Zika, be very careful about mosquitos and be sensible about sex especially if a pregnant woman or woman of reproductive age, since the virus can be sexually transmitted up to 2 months after infection in women and up to 6 months after infection in men”

there are a lot of unknowns at this point, but excellent questions include: will another Zika lineage arise and cause another massive wave of infections, or will it stay in the background at a very low level like West Nile? does being infected previously with another vector-borne virus like Dengue mean anything about how sick or not sick someone gets with Zika?

the prime reason to remain concerned about Zika is the prevention of children from getting Congenital Zika Syndrome as a result of the infection, and the burden of care said children will require throughout their lives